This research will evaluate an innovative program of individual and family counseling for caregivers of older people with senile dementia, as a way of reducing the burden of care and making home placement feasible for families who desire it. Affecting between 5 and 7 per cent of the older population, senile dementia has an unremitting degenerative course, thereby taking a disproportionate share of mental health and other services available to the aging. While families are often willing to assume major responsibilities for care for an older dementia patient at home, they frequently experience excessive burden in doing so. Case studies and other anecdotal evidence have suggested the possibility of interventions which reduce the burden of caregivers, while maintaining the patient at home. Systematic investigations, however, have been lacking. The present study will compare caregivers receiving individual and family counseling with subjects on a wait list. The intervention has been developed through clinical experience and from research which suggests the relation of burden to several factors in the family situation, including the relationship of the caregiver to patient, the occurrence of specific problem behaviors, and the amount of informal social support. Three to 5 individual counseling sessions will be held with caregivers to provide information about dementia and develop strategies for managing various problems in giving care. After these sessions a family meeting will be held as a way of extending the caregivers' informal supports. Measurement of caregivers' perceived burden, emotional distress, coping patterns and social supports will be made before and after the intervention, and at a comparable time interval for controls. Three month and 1 year follow-ups will also be conducted. In addition, the relationship of the caregivers to patients, whether primary caregivers are husbands, wives or daughters, will be considered for its effects on outcome. This research will provide information on the extent to which community care for senile dementia is feasible, without causing adverse effects on family members. It will also yield specific information for mental health and other service providers for working with this group.